Journal of Bone and Joint Infection最新文献

{"title":"Acute or chronic periprosthetic joint infection? Using the ESR ∕ CRP ratio to aid in determining the acuity of periprosthetic joint infections.","authors":"Zachary K Christopher,&nbsp;Kade S McQuivey,&nbsp;David G Deckey,&nbsp;Jack Haglin,&nbsp;Mark J Spangehl,&nbsp;Joshua S Bingham","doi":"10.5194/jbji-6-229-2021","DOIUrl":"10.5194/jbji-6-229-2021","url":null,"abstract":"<p><p><b>Introduction</b>: The gold standard for determining the duration of periprosthetic joint infection (PJI) is a thorough history. Currently, there are no well-defined objective criteria to determine the duration of PJI, and little evidence exists regarding the ratio between ESR (mm/h) and CRP (mg/L) in joint arthroplasty. This study suggests the ESR  <math><mo>/</mo></math>  CRP ratio will help differentiate acute from chronic PJI. <b>Methods</b>: Retrospective review of patients with PJI was performed. Inclusion criteria: patients <math><mrow><mo>></mo> <mn>18</mn></mrow> </math>  years old who underwent surgical revision for PJI and had documented ESR and CRP values. Subjects were divided into two groups: PJI for greater (chronic) or less than (acute) 4 weeks and the ESR  <math><mo>/</mo></math>  CRP ratio was compared between them. Receiver-operating characteristic (ROC) curves were evaluated to determine the utility of the ESR  <math><mo>/</mo></math>  CRP ratio in characterizing the duration of PJI. <b>Results</b>: 147 patients were included in the study (81 acute and 66 chronic). The mean ESR  <math><mo>/</mo></math>  CRP ratio in acute patients was 0.48 compared to 2.87 in chronic patients ( <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> ). The ESR  <math><mo>/</mo></math>  CRP ROC curve demonstrated an excellent area under the curve (AUC) of 0.899. The ideal cutoff value was 0.96 for ESR  <math><mo>/</mo></math>  CRP to predict a chronic ( <math><mrow><mo>></mo> <mn>0.96</mn></mrow> </math> ) vs. acute ( <math><mrow><mo><</mo> <mn>0.96</mn></mrow> </math> ) PJI. The sensitivity at this value was 0.74 (95 % CI 0.62-0.83) and the specificity was 0.90 (95 % CI 0.81-0.94). <b>Conclusions</b>: The ESR  <math><mo>/</mo></math>  CRP ratio may help determine the duration of PJI in uncertain cases. This metric may give arthroplasty surgeons more confidence in defining the duration of the PJI and therefore aid in treatment selection.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"229-234"},"PeriodicalIF":0.0,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39017112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periprosthetic hip infections in a Swedish regional hospital between 2012 and 2018: is there a relationship between <i>Cutibacterium acnes</i> infections and uncemented prostheses?","authors":"Urban Hedlundh,&nbsp;Michail Zacharatos,&nbsp;Jonas Magnusson,&nbsp;Magnus Gottlander,&nbsp;Johanna Karlsson","doi":"10.5194/jbji-6-219-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-219-2021","url":null,"abstract":"<p><p>The purpose of this study was to evaluate patients requiring in-patient care due to a periprosthetic joint infection (PJI), with respect to bacterial agents, surgical treatment, antibiotics, and outcome. We retrospectively identified all infected total hip arthroplasties (THAs) in a Swedish regional hospital during a 7-year period (2012-2018) and reviewed medical records and microbiological data. A total of 89 infected THAs in 87 patients were identified. Standardized treatment with debridement with retention of the implant and antibiotics (DAIR) was initially performed in 53 cases (60 %), one or two stage revisions in 33 cases (37 %), and an immediate Girdlestone in 3 cases (3 %). Infection eradication was seen in 77 PJIs (87 %) in addition to six patients (7 %) ending up with a permanent but uninfected Girdlestone. All six patients with manifest failures were infected with <i>Staphylococcus aureus</i>, two of which were also polymicrobial. <i>Cutibacterium acnes</i> was found in 18 of 89 patients (16 %) distributed in 15 uncemented implants but only in 3 hybrids and cemented arthroplasties, while remaining pathogens were equally distributed in uncemented THAs ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>31</mn></mrow> </math> ) and THAs with at least one cemented component ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>40</mn></mrow> </math> ; <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.003</mn></mrow> </math> ). Eradication was achieved in all 18 patients when <i>Cutibacterium acnes</i> was the only culture ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>14</mn></mrow> </math> ) or clearly dominant among positive cultures ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>4</mn></mrow> </math> ). DAIR was successful in selected postoperative infections up to 6 months after hip replacement. <i>Cutibacterium acnes</i> infections in hip arthroplasty may be underdiagnosed. Cemented components in THAs seem to protect from colonization with <i>Cutibacterium acnes</i>.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"219-228"},"PeriodicalIF":0.0,"publicationDate":"2021-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39017111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soft-tissue thickness radiographic measurement: a marker to evaluate acute periprosthetic joint infection risk in total hip replacement.","authors":"Laura Rey Fernández,&nbsp;Francesc Angles Crespo,&nbsp;Silvia María Miguela Álvarez,&nbsp;Martí Carles Bernaus-Johnson,&nbsp;Agustí Bartra Ylla,&nbsp;Lluís Font-Vizcarra","doi":"10.5194/jbji-6-211-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-211-2021","url":null,"abstract":"<p><p>The objective of our study was to evaluate the association between acute periprosthetic joint infection (APJI) and radiographic measurement of soft-tissue thickness in elective total hip replacement surgery. A case-control study was conducted to compare the soft-tissue thickness radiographic measurement (SRM) at the hip in patients diagnosed with APJI based on Tsukayama et al. (2003) criteria after total hip replacement with patients that were not infected, at a single institution from 2013 to 2019. To minimize selection bias, each case was matched with two controls using the following methodology: patients of the same sex, with an age variation of <math><mo>±</mo></math> 5 years, and nearest in surgery date to the cases were selected. All postoperative radiographs were performed in the first 24 h after total hip arthroplasty (THA) surgery as it is protocolized in our institution. Soft-tissue thickness radiographic measurement was defined as the distance from the tip of the greater trochanter to the skin following a perpendicular line to the femoral diaphysis in postoperative anteroposterior hip radiographs. In total, 78 patients were included (26 cases and 52 controls). The SRM median of the cases was 76.19 mm (SD: 26.518) and 53.5 mm (SD: 20.47) in controls. A multivariate logistic regression model showed an independent association between APJI and SRM (odds ratio (OR)  <math><mo>=</mo></math>  1.033, 95 % confidence interval (CI) 1.007-1.059, <math><mrow><mi>p</mi> <mo>=</mo> <mn>0</mn></mrow> </math> .012). Patients with an SRM greater than 60 mm had a 7-fold increase in the odds of APJI (OR  <math><mo>=</mo></math>  7.295, 95 % CI  <math><mo>=</mo></math>  2.364-22.511, <math><mrow><mi>p</mi> <mo><</mo> <mn>0</mn></mrow> </math> .001). The results of our study suggest an association between large SRM at the hip and the risk of APJI in patients with primary total hip arthroplasty. SRM may be a helpful and easy tool for evaluating the risk of APJI before elective primary total hip replacement surgery.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"211-217"},"PeriodicalIF":0.0,"publicationDate":"2021-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39017110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of invasive non-typeable <i>Haemophilus influenzae</i> spondylodiscitis and periprosthetic joint infection.","authors":"Kevin Sermet,&nbsp;François Demaeght,&nbsp;Isabelle Alcaraz,&nbsp;Nathalie Viget,&nbsp;Julie Dauenhauer,&nbsp;Eric Senneville,&nbsp;Olivier Robineau","doi":"10.5194/jbji-6-207-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-207-2021","url":null,"abstract":"<p><p>A non-typeable <i>Haemophilus influenzae</i> (NTHi) was responsible for an invasive infection including bacteremia, spondylodiscitis with epidural abscess, and periprosthetic hip infection in a 79-year-old woman, triggered by a superinfected ethmo-orbital mucocele. Surgical drainage and antibiotic therapy allowed recovery. PET-scan full cartography of NTHi infection dissemination enabled the discovery of spondylodiscitis. This rare cause of spondylodiscitis and periprosthetic joint infection suggests a complete work-up is unavoidable.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"207-209"},"PeriodicalIF":0.0,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39096935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to McNally's comment on \"Bioactive glass S53P4 vs. autologous bone graft for filling defects in patients with chronic osteomyelitis and infected non-unions - a single center experience\" by Steinhausen et al. (2021).","authors":"Eva Steinhausen,&nbsp;Rolf Lefering,&nbsp;Martin Glombitza,&nbsp;Nikolaus Brinkmann,&nbsp;Carsten Vogel,&nbsp;Bastian Mester,&nbsp;Marcel Dudda","doi":"10.5194/jbji-6-203-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-203-2021","url":null,"abstract":"Eva Steinhausen1,3, Rolf Lefering2, Martin Glombitza1, Nikolaus Brinkmann1, Carsten Vogel3, Bastian Mester3, and Marcel Dudda1,3 1Department of Orthopedic and Trauma Surgery, BG Klinikum Duisburg, University of Duisburg-Essen, 47249 Duisburg, Germany 2Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne, Germany 3Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University of Duisburg Essen, Essen, Germany","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"203-205"},"PeriodicalIF":0.0,"publicationDate":"2021-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8188879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39089932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Bioactive glass S53P4 vs. autologous bone graft for filling defects in patients with chronic osteomyelitis and infected non-unions - a single center experience\" by Steinhausen et al. (2021).","authors":"Martin McNally","doi":"10.5194/jbji-6-199-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-199-2021","url":null,"abstract":"I read with interest the recent paper by Steinhausen et al. (2021). This paper reports the outcome of a retrospective review of bioactive glass compared to autologous bone graft (ABG) in a staged surgical protocol for treating established bone infection. The authors claim that bioglass is equally effective as ABG in eradicating infection but acknowledge that their evidence is weak. The surgical treatment of chronic bone infection has been reported for well over a century. In 1931, Jacob Kulowski published his classical series of 130 cases of osteomyelitis, treated by Orr’s method (Kulowski, 1931). His surgical debridement technique was similar to that described by Steinhausen et al. (2021), and he achieved a recurrence rate of 24 % (mean follow-up: 19 months), in the pre-antibiotic era, with no defect fillers. In this new series of 83 patients, the recurrence rate with bioglass was 29 % and 19 % for ABG. Clearly the addition of bioglass or bone graft has not improved outcome. The authors state that the longer follow-up period for the ABG group is not a source of bias because “most complications occurred within 12 months”. This same group previously published 50 of their 51 bioglass cases (Malat et al., 2018) with a mean follow-up of 12.3 months and a recurrence rate of 14 %. This has increased to 29 % with a longer follow-up (mean 20.5 months). It would appear that the recurrence rate doubled in the 8 months after the first year. There are no large randomized trials directly comparing the use of bioglass with other options, and the authors correctly report that outcomes of small studies are inconclusive. However, there are two high-quality animal studies (Xie et al., 2009; Boot et al., 2020). In a rabbit model of MRSA osteomyelitis, Xie et al. (2009) reported that bioglass was no more effective than debridement alone (success rate 36 % for debridement and 18 % for debridement and bioglass) but the addition of local antibiotics to calcium sulfate or bioglass increased success to 73 % and 81 % respectively. Boot et al. (2020) studied the effect of hydrogel and bioglass in an infected tibial nail model. They showed that bioglass or hydrogel without antibiotics produced no reduction in infection, but vancomycin-loaded hydrogel could eradicate established infection. It has been widely claimed that bioglass has the advantage of reducing the risk of antimicrobial resistance. This paper shows that cases treated with bioglass required significant additional systemic antimicrobial therapy after repeated surgery or recurrence. It has been shown that repeated surgery promotes change in bacterial cultures (Rupp et al., 2020). Recurrent, and often suboptimal, systemic therapy drives selection pressure and multi-drug resistance. There is no evidence that local antimicrobial therapy contributes to this. The recent study of Bidossi et al. (2020) demonstrated that prolonged exposure to high-dose local antibiotics in a ceramic carrier was not associated with any ad","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"199-201"},"PeriodicalIF":0.0,"publicationDate":"2021-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8188880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39107795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pursuit of the ideal antiseptic irrigation solution in the management of periprosthetic joint infections.","authors":"Ahmed Siddiqi,&nbsp;Zuhdi E Abdo,&nbsp;Bryan D Springer,&nbsp;Antonia F Chen","doi":"10.5194/jbji-6-189-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-189-2021","url":null,"abstract":"<p><p>Irrigation and debridement in the treatment of periprosthetic joint infection (PJI) serve an integral role in the eradication of bacterial burden and subsequent re-infection rates. Identifying the optimal irrigation agent, however, remains challenging, as there is limited data on superiority. Direct comparison of different irrigation solutions remains difficult because of variability in treatment protocols. While basic science studies assist in the selection of irrigation fluids, in vitro results do not directly translate into clinical significance once implemented in vivo. Dilute povidone iodine, hydrogen peroxide, chlorhexidine gluconate, acetic acid, sodium hypochlorite, hypochlorous acid, and preformed combination solutions all have potential against a broad spectrum of PJI pathogens with their own unique advantages and disadvantages. Future clinical studies are needed to identify ideal irrigation solutions with optimal bactericidal properties and low cytotoxicity for PJI treatment.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"189-198"},"PeriodicalIF":0.0,"publicationDate":"2021-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39096934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascularized fibula flap in the management of segmental bone loss following osteomyelitis in children at a Ugandan hospital.","authors":"Antonio Loro,&nbsp;Andrew Hodges,&nbsp;George William Galiwango,&nbsp;Francesca Loro","doi":"10.5194/jbji-6-179-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-179-2021","url":null,"abstract":"<p><p><b>Background</b>: Hematogenous osteomyelitis is commonly observed in the pediatric population across sub-Saharan Africa. This retrospective case series was designed to evaluate the complications and outcomes of treatment using a vascularized fibula flap (VFF) to fill segmental bone defects secondary to osteomyelitis in children in a low-resource setting in CoRSU Rehabilitation Hospital, Uganda. <b>Methods</b>: Clinical notes and radiographs of children with a diagnosis of osteomyelitis that subsequently underwent a VFF procedure between October 2013 and December 2017 were reviewed. All patients were clinically and radiographically evaluated in 2019. <b>Results</b>: Forty-four children, with an average bone defect of 10.5 cm, were included. Eighty-four percent of children had successful VFF limb reconstruction. Integration of the graft was radiologically sound in 20.8 weeks on average. The postoperative phase was uneventful in 29 % of patients. Complications were observed in the remaining patients, including flap failure (6), donor leg neurapraxia (3), cutaneous paddle necrosis (11), graft fracture (2), skin graft loss (6), fixator failure (1) and non-union (2). Functional outcomes were rated as excellent in 13 patients, good in 14, fair in 9 and poor in 8. There was no recurrence of the bone infection in any of the enrolled children. <b>Conclusion</b>: Despite being a complex and demanding procedure, VFF is a good option for reconstructing post-osteomyelitis bone defects, particularly when associated with loss of soft tissue envelope. Considering the more than satisfactory functional and clinical outcomes, this procedure should be kept in mind for these complex pediatric cases of bone and soft tissue loss, even in a low-resource setting.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"179-187"},"PeriodicalIF":0.0,"publicationDate":"2021-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39096933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Costal osteomyelitis due to <i>Bartonella</i> <i>henselae</i> in a 10-year-old girl.","authors":"Arnaud Salmon-Rousseau,&nbsp;Christelle Auvray,&nbsp;Quentin Besset,&nbsp;Claire Briandet,&nbsp;Claire Desplantes,&nbsp;Pascal Chavanet","doi":"10.5194/jbji-6-171-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-171-2021","url":null,"abstract":"<p><p><i>Bartonella henselae</i> is the bacterial agent responsible for cat scratch disease. This infection is frequently the cause of localized lymphadenitis in children. It is also sometimes responsible for endocarditis, encephalitis, hepatic peliosis and in rare cases osteomyelitis. We describe the second known case of unifocal thoracic osteomyelitis in a 10-year-old child.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"171-178"},"PeriodicalIF":0.0,"publicationDate":"2021-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39096932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip aspiration culture: analysing data from a single operator series investigating periprosthetic joint infection.","authors":"Connor J Barker,&nbsp;Alan Marriot,&nbsp;Munir Khan,&nbsp;Tamsin Oswald,&nbsp;Samuel J Tingle,&nbsp;Paul F Partington,&nbsp;Ian Carluke,&nbsp;Mike R Reed","doi":"10.5194/jbji-6-165-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-165-2021","url":null,"abstract":"<p><p><b>Introduction</b>: We undertook this study to know the sensitivity, specificity and post-test probabilities of hip aspiration when diagnosing periprosthetic hip infections. We also examined \"dry tap\" (injection with saline and aspiration) results and aspiration volumes. <b>Methods</b>: This is a retrospective cohort study of patients aspirated for suspected periprosthetic joint infection between July 2012 and October 2016. All aspirations were carried out by one trained surgical care practitioner (SCP). All aspirations followed an aseptic technique and fluoroscopic guidance. Aspiration was compared to tissue biopsy taken at revision. Aspiration volumes were analysed for comparison. <b>Results</b>: Between January 2012 and September 2016, 461 hip aspirations were performed by our SCP. Of these 125 progressed to revision. We calculated sensitivity 59 % (confidence interval (CI) 35 %-82 %) and specificity 94 % (CI 89 %-98 %). Pre-test probability for our cohort was 0.14. Positive post-test probability was 0.59 and negative post-test probability 0.06. Aspiration volume for infected ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>17</mn></mrow> </math> ) and non-infected ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>108</mn></mrow> </math> ) joints was compared and showed no significant difference. Dry taps were experienced five times; in each instance the dry tap agreed with the biopsy result. <b>Conclusions</b>: Our data show that hip aspiration culture is a highly specific investigation for diagnosing infection but that it is not sensitive. Aspiration volume showed no significant difference between infected and non-infected groups. Each time a joint was infiltrated with saline to achieve a result, the result matched tissue sampling.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"165-170"},"PeriodicalIF":0.0,"publicationDate":"2021-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39060474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}